ATI Predictor Practice

1. Pancreatitis: -- Upper left quadrant pain (abdominal pain) Priority Finding: *Absent bowel sounds* (indicative of paralytic ileus. *Expected findings:* (H) amylase + (H) Lipase Liver enzymes elevated Glucose may be elevated - (L) insulin N/V, jaundice, (H) WBC 2. Hepatitis A: Contaminated Food 3. Lab values (Per ATI): *BUN*: 10-20 *Cr*: 0.6-1.2 *Creatinine Clearance*: 80-139 *Na*: 135-145 *K*: 3.5-5 *Ca*: 9-11 *Cl*: 98-106 *Mg*: 1.3-2.1 *Albumin*: 3.5-5 (slow changes in protein) *Prealbumin*: 23-43 (better indication of malnutrition - for acute changes in protein) *Urine Specific Gravity*: 1.010-1.025 *Fasting Glucose*: 110 *Oral glucose tolerance test*: 140 *HbA1c*: 5%; pre-diabetes: 5.7-6.4%; DM: 6.5% *ICP*: 10-15 mm Hg *pH*: 7.35-7.45 *O2*: 95-100% *PaCO2*: 35-45 mm Hg *HCO3*: 22-26 *CO*: 4-7 L/min *D-dimer*: 0.43-2.33 mcg/mL (elevated = clot formation occurred-- pulmonary embolism occurred) *CK-MB*: 0% (30-170 units/L); elevated 4-6 hrs; lasts 3 days *Troponin I*: 0.03 ng/L; elevated @ 3hrs; lasts 7-10 days *Troponin T*: 0.2 ng/L; elevated @3-5hrs; lasts 14-21 days *Cholesterol*: 200 mg/L *HDL*: 35-80 (female): 35-65 (male) -- High Desirable *LDL*: 130 mg/dL -- Low Desirable (up to 70% of total cholesterol) *Triglycerides*: 40-160 (males); 35-135 (females); 55-220 (older adults) -- Evalu- ates Atherosclerosis *RBC*: 4.2-5.4 (female); 4.7-6.1 (male) *WBC*: 5,000-10,000 *Platelets*: 150,000-400,000 *Hgb*: 12-16 (females); 14-18 (males) *Hct*: 37-47 (females); 42-52 (males) (3x Hgb) *PT*: 11-12.5 -- See clotting & vit. K *aPTT*: 30-40 seconds -- Monitor for Heparin; increased if DIC, liver disease *INR*: 2-3 on warfarin (checked with PT) 4. Magnesium Sulfate: Adverse effects: Respiratory paralysis (serious) Depressed or absent reflexes Hypotension Depressed cardiac function 5. Prednisone inhaler: Wait 20-30 seconds between puffs Exhale with pursed lips Rinse mouth afterwards (to decrease chance of infection) hold breath for 10 seconds 6. Detached Retina: "feels like a *curtain* is pulled over my eye" 7. Hypothyroidism: Causes constipation (due to decreased metabolism) 8. Hyperthyroidism: Increase nutritional intake with meals. (due to increased metabolism using up protein, lipid, and carbohydrate stores) *Priority finding*: Increased BP 9. Chest Tubes: Keep collection chamber below lungs 10. Weight applied to skin traction: should be 5-10 lbs max to prevent skin injury 11. Ileostomy bag: "Apply skin barrier" to protect skin from enzyme & bile salts 12. Non-tunneled percutaneous central venous catheter: Place client in tren- delenburg position to provide easier access to vessels & decrease risk of air embolus 13. Newly diagnosed Heart Failure patient: Try to walk at least 3 times a week for exercise 14. Arterial lines: Need pressure bag around the solution, because pressure form an artery is greater than that of the line.